Risk-reducing surgery (prophylactic surgery) involves removing the ovaries and fallopian tubes (bilateral salpingo-oophorectomy) to lower the chance of developing ovarian cancer. It is recommended for individuals at high risk due to genetic factors or family history.
Who Should Consider This Surgery?
You may be a candidate if you have:
- Genetic mutations (e.g., BRCA1, BRCA2, Lynch syndrome).
- Strong family history of ovarian, breast, or related cancers.
- Completed childbearing and wish to reduce cancer risk.
Genetic testing and counselling are essential first steps.
Benefits of Surgery
- Lowers ovarian cancer risk by up to 90%.
- May reduce breast cancer risk (for BRCA1/2 carriers).
- Peace of mind from proactive risk management.
Risks and Considerations
- Surgical Risks: Infection, bleeding, or anaesthesia complications (rare).
- Early Menopause (if premenopausal): Triggers hot flashes, bone loss, and heart health risks.
- Emotional Impact: Feelings of loss or anxiety about surgery.
- Hormone Replacement Therapy (HRT): May be recommended for menopausal symptoms in some cases (discuss with your doctor).
What to Expect
Before Surgery
- Genetic counselling to confirm risk.
- Pre-surgery tests (bloodwork, imaging).
- Discuss HRT options if needed.
During Surgery
- Performed laparoscopically or via open surgery (1–3 hours under general anaesthesia).
- Ovaries and fallopian tubes are removed; uterus may stay unless otherwise planned.
After Surgery
- Recovery: 2–6 weeks (avoid heavy lifting).
- Menopause Management: HRT, lifestyle changes, or non-hormonal therapies.
- Follow-Up: Regular check-ups to monitor health.
Alternatives to Surgery
- Surveillance:
- Pelvic ultrasounds and CA-125 blood tests (less effective than surgery).
- Chemoprevention:
- Birth control pills (may lower risk for some).
Surgery offers the greatest risk reduction.
- Birth control pills (may lower risk for some).
Frequently Asked Questions
Q: Does surgery eliminate all risk?
A: No—there’s still a small risk of primary peritoneal cancer (similar to ovarian cancer).
Q: Can I delay surgery if I want children?
A: Yes—discuss fertility preservation options (e.g., egg freezing) with your doctor.
Q: Will I need HRT after surgery?
A: If premenopausal, HRT can ease menopause symptoms but may not be advised for BRCA1/2 carriers (varies by case).
Q: Are my fallopian tubes always removed?
A: Yes—emerging research shows some cancers start there.
eGynaecologist Advice:
- Risk reducing surgery for prevention of ovarian cancer is a personal choice however, surgery significantly reduces ovarian cancer risk for high-risk individuals and should consult a gynaecologist for further discussion.
- Early menopause after risk reducing surgery is manageable with medical and lifestyle support and should speak to your gynaecologist for post treatment support.
